Issue link: https://beckershealthcare.uberflip.com/i/653703
26 INFECTION PREVENTION & PATIENT SAFETY 4 Key Elements of Early Sepsis Recognition and Response By Shannon Barnet A n official from Houston Meth- odist Hospital shared lessons learned from the organization's sepsis care improvement initiative imple- mentation in the March edition of e Joint Commission Journal on Quality and Patient Safety. e article was authored by Stephen L. Jones, MD, an assistant clinical mem- ber of the Houston Methodist Research Institute, and his colleagues. According to Dr. Jones, the Sepsis Early Recognition and Response Initiative, or SERRI, was implemented at Houston Methodist Hos- pital and 14 other facilities in the Texas Gulf Coast Sepsis Network. SERRI was designed in response to CMS' new requirement that demands hospitals report their performance on a composite process of care measure for severe sepsis and septic shock in 2016. To help meet CMS' requirements, the site-specific implementation incorporat- ed four key elements of SERRI: 1. Engaging hospital leaders 2. Educating bedside nurses and second responders 3. Incorporating a five-item bedside sys- temic inflammatory response system and sepsis screening tool into EHR systems 4. Auditing and collecting feedback using process and outcome data e elements were modified to accommodate differences across the 15 facilities in their missions, staffing levels, clinical processes and medical record systems. By January 2015, all but two of the acute care SERRI sites were screening more than 80 percent of inpatients whose stay was sepsis-associated. Additionally, screening for patients with sepsis-as- sociated stays reached 89 percent to 98 percent in post-acute care sites. e two sites that hadn't reached such levels of screening didn't join the initiative until mid-2014. n Predictive Model Reduces C. diff Cases in ICU: 3 Study Findings By Shannon Barnet R esearchers found a predictive screening tool and preventive model helped reduce healthcare-ac- quired Clostridium difficile infections in a study published in the American Journal of Infection Control. The predictive screening tool was developed using risk factors identified in the previous literature and the retrospective analysis of the C. diff cases that occurred in critically ill patients in 2013. The tool was used to screen all patients admitted to one hospital intensive care unit. Ultimately, the study revealed the following: 1. During the year-long study, 217 high-risk C. diff patients were identified, 62 of whom failed to meet the study criteria, resulting in a study population of 157 patients. 2. Of the entire study population, 10 cases of health- care-acquired C. diff occurred during the preinterven- tion phase, for an overall incidence rate of roughly 14.7, according to the study. 3. During the intervention phase, two C. diff infections were identified, for an incidence rate of 3.12. The reduction was considered statistically significant. "A strategy for identifying patients at increased risk and implementation of multidisciplinary risk-mitigation strategies is effective in reducing incidence of [healthcare-acquired C. diff infections]," concluded the study authors. n Can Chlorhexidine Wipes Prevent Drug-Resistant HAIs in the ICU? By Shannon Barnet R esearchers in Bangkok recently examined the effectiveness of daily bathing with 2 percent chlorhexidine-impregnated washcloths in preventing multidrug-resistant gram-positive bacterial colonization and bloodstream infection. The results of the study were published in Infection Control & Hospi- tal Epidemiology. The study was conducted in four medical intensive care units in Thailand from December 2013 to January 2015. Nearly 500 patients in the study were cleaned with either non-antimicrobial soap (241 patients) or the chlor- hexidine-impregnated wipes (240 patients). The researchers observed favorable events at day 14 in 34.8 percent of patients in the control group and 28.6 percent in the chlorhexidine group. The median multidrug-resistant bacteria colonization-free times were 5 days in both groups, and the infection rate and length of stay was roughly the same between the two patient cohorts. Ultimately, the effectiveness of using 2 percent ch- lorhexidine-impregnated washcloths to prevent bacteria colonization and hospital-acquired infections in ICU patients was not proven. n